The Evolution of the Management System of Hospitals in Greece

The administration system of the health units -hospitals of the country presented different alteration during its course from the formation of the Greek state until now days. To be more specific, we can observe that:

a) During the first period, the management of the few hospitals in the country is practiced by a complicated and multiform systems. Moreover, some hospitals were managed by a fraternity, other by a committee, other by an administrative committee and finally other by a board of directors. In any case, members of these collective sectors are members of the state such as mayors, chief of the community, simply private citizens, or well off citizens who participated in the formation and function of some hospitals as benefactors. But, supreme place to these of organisation and management of the hospitals has the private initiative because of the financial adversity of the state. The turn of the health sector to the well off citizens is obvious, as they dispose great deal of money for health. During this period, the state just supervises the few hospitals, public benevolent and state hospitals.

b) The second period from the reform of the compulsory Law 965/1937 until the year 1983 is characterized by two substantial legislative Acts, which changed radically the border of the organisation and management of health units. Firstly, the compulsory Law 965/1937 establishes officially the boards of the directors as the institution initially covered public hospitals of the country and in the meantime the hospitals of the rest of the categories. It is also established for the first time along with that institution, the institution of the Governmental Trustee. The second legislative Act of that period is the Law Order 2592/1953, through which public health is put into a new basis according to the demands of that period. The Administrative system of public hospitals remains the same without particular changes to it.

c) During the third period from the establishment of the National Health System - Law 1397/1983 until nowadays. This period is characterized by two great facts:

1. The foundation of National Health System [Law 1397/1983]. It is a historical event for health in Greece. The health system has for the first time totally public features and the civilian enjoys the social good of health without any cost. However, the administrative system of health preserves from the establishment of the state until nowadays its centralizing character.

2. The reformation of the N.H.S, Law 2889/2001. It leads to the radical change of the valid administrative system after 175 years of state function. The country is divided into health districts, where in each one the peripheral health system is created (P.H.S.). It is managed by an administrative board, in which substantial authorities are given for the first time in history of Greek health sector. Consequently, we have today a decentralizing management system in health, which is applied by the seventeen (17) peripheral health systems in Greece.